MRI study of midsagittal diameter of lumbar canal in North Indian population and its correlation with gender

Abstract

Background: Low backache and nerve root compression are the commonest cause of occupational and domestic disability in industrialized societies. It is a common cause of morbidity, disability and loss of productivity in elderly population as well as in young due to the changes in lifestyle. The knowledge of anatomical variations in lumbar spine might help in understanding the etiology as well as pathology of low back pain It is well established that the morphometric data varies within different sex, race and regions. The clinical significance of these variations and differences in morphometric assessment of lumbar spine has been reported in the past from several countries.

Aim: To study the normal midsagittal diameter of lumbar canal by magnetic resonance imaging in North Indian population and its correlation with gender.

Materials & methods: Study was carried out in the Department of Anatomy in collaboration with Department of Radio diagnosis Era’s Lucknow Medical College & Hospital, Lucknow. 130 Subjects in the age group of 20-70 yrs who underwent MRI of lumbar spine.

Results: MRI lumbar spine revealed the antero-posterior/midsagittal diameter of canal was comparatively smaller in the North Indian population. The canal was narrowest at L4-L5 (0.95cm) and widest at L1-L2 (2.19cm). In both males and females, the anteroposterior diameter of canal was widest at L1-L2 level 2.19cm and 2.01 cm respectively. The anteroposterior diameter of the spinal canal showed a gradual decrease from L1 to L5, with males consistently showing larger diameters than females.

Conclusion: The knowledge of anatomical variations in lumbar spine might help in understanding the etiology as well as pathology of low back pain. The dimensions of the lumbar canal that were collected could be used as a baseline point for evaluation of patients presenting with low back pain and potential spinal canal stenosis. Also, the findings from the study could be used in the evaluation of patients with spinal stenosis. Therefore, it is necessary to continue research in the context of the clinical applicability of the described parameters in the process of evaluation and eventual prediction of the operative outcome.